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Scientific Oral Presentations

Care Equity, Quality, and Safety

Session: Scientific Oral Presentations 2 - Care Equity, Quality, and Safety

Interventions to Reduce Healthcare Utilization for Non-English Language Preference Patients After Tonsillectomy

Monday, September 30, 2024
8:36 AM – 8:42 AM EDT
Location: MBCC, 235-237
Disclosure(s):
Meredith N. Lind, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kris R. Jatana, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Thomas J. Javens, BBA:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Inequities in healthcare delivery continue to impact access to care and outcomes, particularly for pediatric patients. Compared with those of English language preference (ELP), patients of non-English language preference (NELP) are at especially high risk of increased complications and healthcare utilization, including Urgent Care (UC) and Emergency Department (ED) visits.

Methods: We initiated a quality Improvement (QI) study at a tertiary pediatric hospital, with the goal to decrease the incidence of UC/ED utilization in NELP families after tonsillectomy. Baseline data collection began in 2019 and key drivers were defined. Interventions were initiated by December 2020, including improving translated postoperative education materials, consistent discussion on tonsillectomy technique options, postoperative pain medication charts, providing direct access interpreter phone numbers, and initiating a routine postoperative nurse phone call for education and questions. Post-intervention data was collected from January 2021 until November 2023. The primary outcome measured was overall return to UC/ED within 30 days after tonsillectomy. Additional data collected included demographics, language spoken, reason for surgery, primary reason for return, and disposition.

Results: Between 2019-2023, a total of 11,345 patients underwent tonsillectomy: 10,373 (91.4%) ELP and 972 (8.6%) NELP. After interventions, there was a 76% reduction (7.73% in 2019 to 1.87% in 2023) for NELP patients who were discharged directly from the UC/ED. In 2019, there was a statistically significant difference for ED utilization between NELP and ELP patients (p = 0.024). In 2023, there was a slight but not statistically significant difference between the UC/ED utilization (ELP = 1.5% and NELP = 1.87%, p = 0.3).

Conclusions: This QI study demonstrated that a set of thoughtful interventions for NELP patients/caregivers can significantly reduce minor and non-operative returns to the ED. The described changes may improve the overall postoperative experience for NELP patients and families, while reducing the use of UC/ED resources.

    Presenting Author(s)

  • Meredith N. Lind, MD

    Professor of Otolaryngology
    1. Nationwide Children's Hospital Department of Otolaryngology 2. The Ohio State University College of Medicine
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Senior Author(s)

  • Meredith N. Lind, MD

    Professor of Otolaryngology
    1. Nationwide Children's Hospital Department of Otolaryngology 2. The Ohio State University College of Medicine
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Kris R. Jatana, MD

    Professor, Otolaryngology-Head and Neck Surgery; Surgical Director for Clinical Outcomes; Director of Pediatric Otolaryngology Quality Improvement
    Nationwide Children’s Hospital and Ohio State
    Columbus, OH, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • TJ

    Thomas J. Javens, BBA

    Quality Strategist/Consultant
    Nationwide Childrens Hospital Center for Clinical Excellence
    Columbus, Ohio, United States

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • KM

    Kristyn Moss, RN

    RN Clinical Leader
    Nationwide Children's Hospital
    Columbus, Ohio, United States

    Disclosure information not submitted.